Should I Obtain Serum Urea Nitrogen and Creatinine Values for Every Patient before I Inject Contrast Media?
Not every patient is at risk of developing contrast agent induced nephropathy, so recent values of serum urea nitrogen (ie, BUN) and creatinine are not needed in every patient. As will be discussed, the risk is confined to patients with underlying compromise of normal renal function (8). If a patient has known renal dysfunction, it is important to have recent measurements of serum urea nitrogen and creatinine (eg, within the preceding month) to make sure that the patient s renal function is stable. For all other patients, it is important to find out if they have risk factors for renal problems. These factors include diabetes mellitus; history of recurrent renal stones or recurrent urinary tract infections; history of bladder outlet obstruction (eg, benign prostatic hypertrophy or bladder prolapse); recent history of an event known to cause a risk of renal damage, such as major surgery, dehydration, or cardiogenic shock; and use of nephrotoxic medications such as gentamycin, high-dose n
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